Individual
CODY S. LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
602 S BUSEY AVE, #1, URBANA, IL 61801-4092
(314) 605-8942
Mailing address
602 S BUSEY AVE, #1, URBANA, IL 61801-4092
(314) 605-8942
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.101685
IL
Other
Enumeration date
08/06/2016
Last updated
08/06/2016
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